Tidbit Tuesday

GINA KOLATA wrote a very interesting Article for the New York Times which was published on January 17, 2011. Entitled Close Look at Orthotics Raises a Welter of Doubts, she discusses the use and benefits of orthotics in your shoes.

The article is worth reading whether you wear orthotics or not. I am only posting a selection of quotes here.

For more than 30 years Dr. Nigg, a professor of biomechanics and co-director of the Human Performance Lab at the University of Calgary in Alberta, has asked how orthotics affect motion, stress on joints and muscle activity.

Do they help or harm athletes who use them? And is the huge orthotics industry — from customized shoe inserts costing hundreds of dollars to over-the-counter ones
sold at every drugstore — based on science or on wishful thinking?

His overall conclusion: Shoe inserts or orthotics may be helpful as a short-term solution, preventing injuries in some athletes. But it is not clear how to make inserts that work. The idea that they are supposed to correct mechanical-alignment problems does not hold up.

Joseph Hamill, who studies lower-limb biomechanics at the University of Massachusetts in Amherst, agrees. “We have found many of the same results,” said Dr. Hamill, professor of kinesiology and the director of the university’s biomechanics laboratory. “I guess the main thing to note is that, as biomechanists, we really do not know how orthotics work.”

Orthotists say Dr. Nigg’s sweeping statement does not take into account the benefits their patients perceive.

The key measure of success, said Jeffrey P. Wensman, director of clinical and technical services at the Orthotics and Prosthetics Center at the University of Michigan, is that patients feel better.

“The vast majority of our patients are happier having them than not,” he said about orthotics that are inserted in shoes.

I have added the boldness. In my experience, when I first starting running, I received no benefit from orthotics. The pain/injury I experienced just moved from my foot, to my knee, to my hip and then to the other leg and my orthotics just changed denseness and location. My personal experience was what led me to take off my shoes and run natural. However, I do know others that stop having knee pain the moment they receive their new insole. Perception?? Placebo?? Anecdotal??

As for “corrective” orthotics, he says, they do not correct so much as lead to a reduction in muscle strength.

The theory is that because we wear shoes, we have weak foot muscles which leads us to correct the shoe when instead we should be increasing the strength in our feet.

So why shouldn’t Jason — or anyone, for that matter — just go to a store and buy whatever shoe feels good, without worrying about “correcting” a perceived biomechanical defect?

“That is exactly what you should do,” Dr. Nigg replied.

For a long time I have wondered about our need to correct things that aren't broken, just because they look different to what we perceive to be normal.

I have obviously quoted sections of the article that interest me or are relevant to me in same way. The quotes may or may not be taken out of context so please go read the full article, which also gives the story of Jason and his flat feet.

I would love to hear your experience of orthotics.